X-Message-Number: 14609 From: "Igor Artyuhov" <> Subject: Perftoran: possible use in cryonics? Date: Tue, 3 Oct 2000 16:06:14 +0400 Perftoran is a blood substitute that was developed in Russia as long as about 20 years ago, but only recently approved for medical usage. In fact it was widely used by military medics during the war in Afghanistan to treat massive blood losses, burnings et al. At that time it has saved many soldiers' lives, but due to some cases of side effects it wasn't approved for general application. As recent studies revealed, except for rare cases of individual intolerance, majority of side effects occurred due to either improper quality of product or improper conditions of storage. About a year ago Perftoran was approved for application in Russia. It happened that Perftoran, being developed as oxygen carrying blood substitute, has many more interesting features. Among them are: - ability to diminish blood viscosity, thus improving blood circulation in thin vessels, - antioxidative properties, - ability to stabilize cell membranes and - sorbtion properties. Intravenal injections of Perftoran distinctly improved state of patients with brain or heart ischemia. It seems to me worth studying the possibilities to use Perftoran either as a component of perfusion liquid for cryopreservation, or for pre-mortem injections to diminish impact of ischemia, or both. Igor Artyuhov, ------------------------------------------------ Ministry of Health of Russian Federation Approved by: Pharmacologic State Committee 24" June 1999 Instruction for medical application of Perftoran preparation Perftoranum Registration number 96/50/10 Description Perftoran is 10 volume % emulsion on the base of perfluoroorganic compounds (PFOC), stabilized by 4% surface-active substance (SAS) - Proxanol 268 at average size of emulsion particles 0,03-0,15mkm. It has the following electrolitic composition: sodium chloride - 0,6; potassium chloride - 0,39; magnesium chloride - 0,19; sodium hydrocarbonate - 0,65; sodium hydro phosphate - 0,2; glucose - 2,0; Osmomolarity - 280-310 mOsm/l, pH 7.2 - 7.8. Oxygen solubility 6-7 vol.% (at pO2=760 mm of mercury column). This emulsion has white colour with slightly blue tint, without smell. Pharmacological properties Perftoran - blood substitute preparation with gas-transport function. It is used as an antishock and anti-ischemic agent. The preparation is possessed of rheological, hemodynamic, diuretic, membranestabilizing, cardioprotective and sorbtion properties. Pharmacokinetics Half-life period of Perftoran from blood bed is about 24 hours. Surface-active substances are eliminated from the body via kidney during the first day. Perfluorocarbons are chemically inactive and are not metabolized in the body. Perfluorocarbons are eliminated from body via lungs in expired air during 18-24 month. Indications for application Perftoran is used as a blood substitute preparation with gas transporting function in case of shock, blood losses, multiple trauma, burning of large surface of skin, conditions of apparent death as well as in transplantology. Contraindications Perftoran is contraindicated in patients with hemophilia; at pregnancy it can be used according to vital readings. Perftoran should not be mixed (in one syringe, infusion system or artificial circulation apparatus) with dextrans, polyglucin, reopolyglucin and oxyethylstarch. Use these solutions after the administration of Perftoran or through other peripheral venous access. Method of use and doses Before Perftoran infusion physician should make sight examine of the preparation. The preparation is applicable if there are no any breaks on the bottle, vacuum packing and the label is preserved. The results of sight examination of the bottles and label's data (name of the preparation, manufacturer, series number) should be registered in clinical records. At Perftoran application the biological test is obligatory: after the slow administration of first 5 and following 30 drops it is recommended to make a break for 3 minutes. If there is no any reaction the infusion of the preparation is continued. The results of biotest are registered in clinical records. Perftoran is administered as a drip or continuous infusion in the dose of 5 ml/kg to 30 ml/kg (adults). Single and total doses of the preparation depend on emergency of initial patient' s state and age. To achieve maximum effect the patient should receive adequate oxygenation (40-60%) during 24 hours after or during the infusion. For anti-ischemic protection of transplantants Perftoran is used in artificial circulation apparatus as a perfusate at a dose of 10-40 ml/kg. Side effects The injection of Perftoran can cause allergic reactions (urticaria, skin itch, redness of skin), tachicardia, decrease in blood pressure, hypertermia, headache, chest pain and lumbal pain, difficulty in breathing, anaphylactoid reaction. When adverse reactions occur, the infusion of Perftoran should be stopped and desensibilization, heart-tone, glucocorticoids, vasopressors and other medicaments, which are used in therapy of anaphylactic shock, should be administered without taking out a needle from a vein. Presentation Glass vials containing 50, 100, 200 and 400 ml. Storage Perftoran should be stored frozen at the temperature -4 C to -18 C. Perftoran can be stored after thawing at the temperature +4 C no longer than 2 weeks in refrigerator. The preparation is recommended to thaw at room temperature. After thawing the preparation should be thoroughly shook to receive the homogeneous composition and before the infusion it should be warmed up to +21 C - +23 C. Perftoran may be thawed and refrozen 5 times. The preparation is not suitable for application in case of: Stratification of emulsion (transparent oily drops on the vial bottom even after shaking); Appearance of white sediment on the vial bottom. It is prohibited: to thaw the preparation at temperatures above +30 C. to store the preparation at temperatures below -18 C. Shelf life The shelf life is 3 years at the temperature -4 C to -18 C and 2 weeks at the temperature no higher than +4 C. The preparation is delivered under the doctor's prescriptions. Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=14609